1887

Abstract

Rare invasive fungal infections are increasingly emerging in hosts with predisposing factors such as immunodeficiency. Their timely diagnosis remains difficult, as their clinical picture may initially mimic infections with more common fungal species and species identification may be difficult with routine methods or may require time-consuming subcultures. This often results in ineffective drug administration and fatal outcomes. We report on a patient in their early twenties with mixed cellularity classical Hodgkin lymphoma with a disseminated () infection. Even though pathogen detection and identification was possible via the standard procedure consisting of culture followed by matrix-assisted laser desorption ionisation–time of flight (MALDI-TOF) mass spectrometry, the patient passed away in the course of multi organ failure. Herein, we report on a retrospectively applied experimental diagnostic fungal PCR-analysis used on an EDTA blood sample and consisting of two pan-fungal reactions and seven branch-specific reactions. Regarding invasive infection, this PCR array could considerably shorten time to diagnosis and switch to a targeted therapy with triazoles.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial License. The Microbiology Society waived the open access fees for this article.
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000285
2021-12-03
2024-04-19
Loading full text...

Full text loading...

/deliver/fulltext/acmi/3/12/acmi000285.html?itemId=/content/journal/acmi/10.1099/acmi.0.000285&mimeType=html&fmt=ahah

References

  1. Malani AN, Kauffman CA. Changing epidemiology of rare mould infections: implications for therapy. Drugs 2007; 67:1803–1812 [View Article] [PubMed]
    [Google Scholar]
  2. Auberger J, Lass-Flörl C, Aigner M, Clausen J, Gastl G et al. vasive fungal breakthrough infections, fungal colonization and emergence of resistant strains in high-risk patients receiving antifungal prophylaxis with posaconazole: real-life data from a single-centre institutional retrospective observational study. J Antimicrob Chemother 2012; 67:2268–2273 [View Article] [PubMed]
    [Google Scholar]
  3. Colombo AL, Padovan ACB, Chaves GM. Current knowledge of Trichosporon spp. and Trichosporonosis. Clin Microbiol Rev 2011; 24:682–700 [View Article] [PubMed]
    [Google Scholar]
  4. Chagas-Neto TC, Chaves GM, Melo ASA, Colombo AL. Bloodstream infections due to Trichosporon spp: species distribution, Trichosporon asahii genotypes determined on the basis of ribosomal DNA intergenic spacer 1 sequencing, and antifungal susceptibility testing. J Clin Microbiol 2009; 47:1074–1081 [View Article] [PubMed]
    [Google Scholar]
  5. Ruan SY, Chien JY, Hsueh PR. vasive trichosporonosis caused by Trichosporon asahii and other unusual Trichosporon species at a medical center in Taiwan. Clin Infect Dis 2009; 49:e11–7 [View Article] [PubMed]
    [Google Scholar]
  6. Ozkaya-Parlakay A, Karadag-Oncel E, Cengiz AB, Kara A, Yigit A et al. Trichosporon asahii sepsis in a patient with pediatric malignancy. J Microbiol Immunol Infect 2016; 49:146–149 [View Article] [PubMed]
    [Google Scholar]
  7. Guo L-N, Yu S-Y, Hsueh P-R, Al-Hatmi AMS, Meis JF et al. vasive infections due to Trichosporon: species distribution, genotyping, and antifungal susceptibilities from a multicenter study in China. J Clin Microbiol 2019; 57:e01505-18 [View Article] [PubMed]
    [Google Scholar]
  8. Perlin DS, Rautemaa-Richardson R, Alastruey-Izquierdo A. The global problem of antifungal resistance: prevalence, mechanisms, and management. Lancet Infect Dis 2017; 17:e383–e392 [View Article] [PubMed]
    [Google Scholar]
  9. Sah R, Soin AS, Chawla S, Wadhwa T, Gupta N. Disseminated Trichosporon asahii infection in a combined liver-kidney transplant recipient successfully treated with voriconazole. Immun Inflamm Dis 2019; 7:125–129 [View Article] [PubMed]
    [Google Scholar]
  10. Bassetti M, Righi E, Montravers P, Cornely OA. What has changed in the treatment of invasive candidiasis? A look at the past 10 years and ahead. J Antimicrob Chemother 2018; 73:i14–i25 [View Article] [PubMed]
    [Google Scholar]
  11. Santoro A, Magagnoli M, Spina M, Pinotti G, Siracusano L et al. Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin’s lymphoma. Haematologica 2007; 92:35–41 [View Article] [PubMed]
    [Google Scholar]
  12. Rahn S, Schuck A, Kondakci M, Haas R, Neuhausen N et al. A novel comprehensive set of fungal Real time PCR assays (fuPCR) for the detection of fungi in immunocompromised haematological patients-A pilot study. Int J Med Microbiol 2016; 306:611–623 [View Article] [PubMed]
    [Google Scholar]
  13. NCBI Basic Local Alignment Search Tool (BLAST); 2021 https://blast.ncbi.nlm.nih.gov/
  14. Westerdijk Institute CBS-Database; 2021 http://www.wi.knaw.nl/Collections/
  15. Arendrup MC, Boekhout T, Akova M, Meis JF, Cornely OA et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of rare invasive yeast infections. Clin Microbiol Infect 2014; 20 Suppl 3:76–98 [View Article] [PubMed]
    [Google Scholar]
  16. Go SE, Lee KJ, Kim Y, Choi JK, Kim YJ et al. Catheter-related Trichosporon asahii bloodstream infection in a neutropenic patient with myelodysplastic syndrome. Infect Chemother 2018; 50:138–143 [View Article] [PubMed]
    [Google Scholar]
  17. Rieger C, Geiger S, Herold T, Nickenig C, Ostermann H. Breakthrough infection of Trichosporon asahii during posaconazole treatment in a patient with acute myeloid leukaemia. Eur J Clin Microbiol Infect Dis 2007; 26:843–845 [View Article] [PubMed]
    [Google Scholar]
  18. Chen J, Chen F, Wang Y, Yang L-Y, Miao M et al. Use of combination therapy to successfully treat breakthrough Trichosporon asahii infection in an acute leukemia patient receiving voriconazole. Med Mycol Case Rep 2014; 6:55–57 [View Article] [PubMed]
    [Google Scholar]
  19. Pagano L, Caira M, Candoni A, Offidani M, Fianchi L et al. The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study. Haematologica 2006; 91:1068–1075 [PubMed]
    [Google Scholar]
  20. Ebright JR, Fairfax MR, Vazquez JA. Trichosporon asahii, a non‐ Candida yeast that caused fatal septic shock in a patient without cancer or neutropenia. Clin Infect Dis 2001; 33:E28–E30 33-5-E28 [View Article]
    [Google Scholar]
  21. Fournier S, Pavageau W, Feuillhade M, Deplus S, Zagdanski A-M et al. Use of voriconazole to successfully treat disseminated Trichosporon asahii infection in a patient with acute myeloid leukaemia. Eur J Clin Microbiol Infect Dis 2002; 21:892–896 [View Article] [PubMed]
    [Google Scholar]
  22. de Almeida JN Júnior, Sztajnbok J, da Silva AR Junior, Vieira VA, Galastri AL et al. Rapid identification of moulds and arthroconidial yeasts from positive blood cultures by MALDI-TOF mass spectrometry. Med Myco 2016; 54:885–889 [View Article]
    [Google Scholar]
  23. Sapienza MR, Fuligni F, Agostinelli C, Tripodo C, Righi S et al. Molecular profiling of blastic plasmacytoid dendritic cell neoplasm reveals a unique pattern and suggests selective sensitivity to NF-kB pathway inhibition. Leukemia 2014; 28:1606–1616 [View Article] [PubMed]
    [Google Scholar]
  24. Matsue K, Uryu H, Koseki M, Asada N, Takeuchi M. Breakthrough trichosporonosis in patients with hematologic malignancies receiving micafungin. Clin Infect Dis 2006; 42:753–757 [View Article] [PubMed]
    [Google Scholar]
  25. Bayramoglu G, Sonmez M, Tosun I, Aydin K, Aydin F. Breakthrough Trichosporon asahii fungemia in neutropenic patient with acute leukemia while receiving caspofungin. Infection 2008; 36:68–70 [View Article] [PubMed]
    [Google Scholar]
  26. Mariné M, Bom VLP, de Castro PA, Winkelstroter LK, Ramalho LN et al. The development of animal infection models and antifungal efficacy assays against clinical isolates of Trichosporon asahii, T. asteroides and T. inkin. Virulence 2015; 6:476–486 [View Article] [PubMed]
    [Google Scholar]
  27. Tanyildiz HG, Yesil S, Toprak S, Candir MO, Sahin G. Two case presentations infected by Trichosporon asahii and treated with voriconazole successfully. Case Rep Infect Dis 2015; 2015:651315 [View Article] [PubMed]
    [Google Scholar]
  28. Scharf S, Bartels A, Kondakci M, Pfeffer K, Henrich B et al. Introduction of a bead beating step improves fungal DNA extraction from selected patient specimens. Int J Med Microbiol 2020; 310:151443 [View Article] [PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000285
Loading
/content/journal/acmi/10.1099/acmi.0.000285
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error